Effects of advanced nursing care on quality of life and cost outcomes of women diagnosed with breast cancer.

L. J. Ritz, M. J. Nissen, K. K. Swenson, J. B. Farrell, P. W. Sperduto, M. L. Sladek, R. M. Lally, L. M. Schroeder

Research output: Contribution to journalArticle

70 Citations (Scopus)

Abstract

PURPOSE/OBJECTIVES: To evaluate quality of life (QOL) and cost outcomes of advanced practice nurses' (APNs') interventions with women diagnosed with breast cancer. DESIGN: Randomized clinical trial. SETTING: Integrated healthcare system in a midwestern suburban community. SAMPLE: 210 women with newly diagnosed breast cancer with an age range of 30-85 years. METHODS: The control group (n = 104) received standard medical care. The intervention group (n = 106) received standard care plus APN interventions based on Brooten's cost-quality model and the Oncology Nursing Society's standards of advanced practice in oncology nursing QOL was measured using the Functional Assessment of Cancer Therapy, Mishel Uncertainty in Illness Scale and Profile of Mood States at seven intervals over two years. Information about costs (charges and reimbursement) was collected through billing systems. MAIN RESEARCH VARIABLES: Uncertainty, mood states, well-being, charges, and reimbursement. FINDINGS: Uncertainty decreased significantly more from baseline in the intervention versus control group at one, three, and six months after diagnosis (p = 0.001, 0.026, and 0.011, respectively), with the strongest effect on subscales of complexity, inconsistency, and unpredictability. Unmarried women and women with no family history of breast cancer benefited from nurse interventions in mood states and well-being. No significant cost differences were found. CONCLUSIONS: APN interventions improved some QOL indicators but did not raise or lower costs. IMPLICATIONS FOR NURSING PRACTICE: The first six months after breast cancer diagnosis is a critical time during which APN interventions can improve QOL outcomes. More research is necessary to define cost-effective interventions.

Original languageEnglish (US)
Pages (from-to)923-932
Number of pages10
JournalOncology nursing forum
Volume27
Issue number6
StatePublished - Jul 1 2000

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Nursing Care
Quality of Life
Breast Neoplasms
Costs and Cost Analysis
Oncology Nursing
Uncertainty
Nursing Societies
Nurses
Control Groups
Nursing
Randomized Controlled Trials
Delivery of Health Care
Research
Neoplasms

ASJC Scopus subject areas

  • Oncology(nursing)

Cite this

Ritz, L. J., Nissen, M. J., Swenson, K. K., Farrell, J. B., Sperduto, P. W., Sladek, M. L., ... Schroeder, L. M. (2000). Effects of advanced nursing care on quality of life and cost outcomes of women diagnosed with breast cancer. Oncology nursing forum, 27(6), 923-932.

Effects of advanced nursing care on quality of life and cost outcomes of women diagnosed with breast cancer. / Ritz, L. J.; Nissen, M. J.; Swenson, K. K.; Farrell, J. B.; Sperduto, P. W.; Sladek, M. L.; Lally, R. M.; Schroeder, L. M.

In: Oncology nursing forum, Vol. 27, No. 6, 01.07.2000, p. 923-932.

Research output: Contribution to journalArticle

Ritz, LJ, Nissen, MJ, Swenson, KK, Farrell, JB, Sperduto, PW, Sladek, ML, Lally, RM & Schroeder, LM 2000, 'Effects of advanced nursing care on quality of life and cost outcomes of women diagnosed with breast cancer.', Oncology nursing forum, vol. 27, no. 6, pp. 923-932.
Ritz LJ, Nissen MJ, Swenson KK, Farrell JB, Sperduto PW, Sladek ML et al. Effects of advanced nursing care on quality of life and cost outcomes of women diagnosed with breast cancer. Oncology nursing forum. 2000 Jul 1;27(6):923-932.
Ritz, L. J. ; Nissen, M. J. ; Swenson, K. K. ; Farrell, J. B. ; Sperduto, P. W. ; Sladek, M. L. ; Lally, R. M. ; Schroeder, L. M. / Effects of advanced nursing care on quality of life and cost outcomes of women diagnosed with breast cancer. In: Oncology nursing forum. 2000 ; Vol. 27, No. 6. pp. 923-932.
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AU - Sperduto, P. W.

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